Why you need a pulse oximeter at home, by an ER doc

[Acadie]

This article is excellent, and a real public service--

https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html?action=click&module=Opinion&pgtype=Homepage

[kbutton]

Suggested models for reliable devices?

[TCB]

8 minutes ago, kbutton said:

Suggested models for reliable devices?

I bought a cheap one from Amazon that had reviews from a couple of RTs who said they had checked it against pulse oximeters at work. I did my own test by holding my breath for as long as possible and seeing if it went down. Probably not a very scientific test lol.

[Pen]

26 minutes ago, kbutton said:

Suggested models for reliable devices?

 

I don’t know what’s reliable. They still have some on Amazon, but prices are up. Or less expensive ones gone.   Like for lots of things. 

Edited April 21, 2020 by Pen

[kbutton]

7 minutes ago, kand said:

They appear much harder to come by than they were when I ordered one at the beginning of March, so you may have to go with whatever you can find. I paid less than $15 on Amazon, I was super glad to have it on hand while I was sick. Gave me some reassurance when I was feeling bad and starting to worry.

Okay, that helps makes sense of the prices all over the map! I thought I remember reading a million years ago on here that they were really inexpensive.

[Arcadia]

56 minutes ago, kbutton said:

Suggested models for reliable devices?

I just bought this one from Target because I am asthmatic and my husband says never mind just buy in store instead of Amazon (we don’t have Prime membership)

The oxygen saturation reading is very similar to what I get at the oncologist clinic. The pulse rate is very similar to what I get with my Samsung smartwatch.

https://www.target.com/p/choicemmed-pulse-oximeter/-/A-15025212

This Amazon link looks the same as what we bought 

https://www.amazon.com/ChoiceMMed-Black-Finger-Pulse-Oximeter/dp/B00ZR9MW82

[kbutton]

I got on and bought the first reasonable model that had decent ratings, attestation that it kept up with ones used in healthcare settings, and was available in the next two weeks. 🙂 My preferred color changed from delivery this week vs. "we'll let you know when it's in stock" while I was dithering. I snapped up another color asap. Hopefully it will come in about a week. 

[Pen]

36 minutes ago, Arcadia said:

I just bought this one from Target because I am asthmatic and my husband says never mind just buy in store instead of Amazon (we don’t have Prime membership)

The oxygen saturation reading is very similar to what I get at the oncologist clinic. The pulse rate is very similar to what I get with my Samsung smartwatch.

https://www.target.com/p/choicemmed-pulse-oximeter/-/A-15025212

This Amazon link looks the same as what we bought 

https://www.amazon.com/ChoiceMMed-Black-Finger-Pulse-Oximeter/dp/B00ZR9MW82

 

One thing that looks good on this is it looks like display is set up for person doing a self test to see the display right side up.  

What I got has the display set up to be easy for a healthcare worker to see, but display is upside down for me when self checking.

[Arctic Bunny]

5 minutes ago, Pen said:

 

One thing that looks good on this is it looks like display is set up for person doing a self test to see the display right side up.  

What I got has the display set up to be easy for a healthcare worker to see, but display is upside down for me when self checking.

You can’t put it on the other hand? 

ETA.... the numbers are at the top/bottom, aren’t they? Duh. Sorry

Edited April 21, 2020 by arctic_bunny

[Jean in Newcastle]

I got one at my local pharmacy at the start of this. 
 

I checked it a lot when I has my “undetermined virus “ for six weeks. My O2 sats were generally ok until the last week. Then they started to dip (but came back up right at the time I was about to call the doctor). What was weird was those couple of days when my O2 sats started to dip my fingertips really hurt. I have never heard of that happening. 

[Pen]

4 minutes ago, arctic_bunny said:

You can’t put it on the other hand?

 

It would be backwards to my own eyes whichever hand.  (Some have horizontal display where changed hand might help. Mine is vertical facing right side up for someone who would be facing me. It’s okay if used to it and not mistaking a 9 for a 6 . )

 

 

Edited April 21, 2020 by Pen

[Terabith]

I bought one in February.  I've tested it out a few times, and it seems about right and pretty easy to use.  It was less than $15.

[catz]

This is interesting and good to know,  but not everyone is going to be able to get one of these in the short term.  We’d all be better off if we could get better mask options too.

I have  read stories about EMT trying to convince people they don’t need transport to an ER and hospitals saying don’t come unless you’re really sick and testing being so limited.  I wish we’d put drive through quick places for people to get evaluated quickly with testing.  It’s a cultural and lack of insurance thing to wait to see a doctor here for many American families.  We are losing people and putting people on vents that with earlier treatment may have done fine at home with a nebulizer, or done with oxygen support, etc.  

[Acadie]

11 hours ago, kbutton said:

Suggested models for reliable devices?

 

I bought the TrackAid on Amazon because there were great reviews from health care providers noting they'd checked it for accuracy against hospital models. Better to get one that has a good track record, rather than something thrown together by a manufacturer during COVID-19. Mine was $15 before the pandemic, I bought my parents the same model for $30 a few weeks ago, and now it's $35. 

Both my and my parents' TrackAids seem to have worked well, including showing lower O2 sats before dh uses his inhalers, and slightly higher sats afterward. 

Calling a local pharmacy to see what they have in stock would be a good option as well. At this point I think prices $30-$50 for a decent unit (one with good reviews on Amazon, or one from your local pharmacy) are reasonable due to high demand. 

I have read that the apps that can be used with cell phone cameras are not reliable, so I'd go with a dedicated unit.

Edited April 21, 2020 by Acadie

[Acadie]

59 minutes ago, FuzzyCatz said:

This is interesting and good to know,  but not everyone is going to be able to get one of these in the short term.  We’d all be better off if we could get better mask options too.

I have  read stories about EMT trying to convince people they don’t need transport to an ER and hospitals saying don’t come unless you’re really sick and testing being so limited.  I wish we’d put drive through quick places for people to get evaluated quickly with testing.  It’s a cultural and lack of insurance thing to wait to see a doctor here for many American families.  We are losing people and putting people on vents that with earlier treatment may have done fine at home with a nebulizer, or done with oxygen support, etc.  

 

Totally agree with everything you've said here. The obstacles to accessing care were enormous before coronavirus, and only more so now. We need universal, free, easily accessible coronavirus testing & evaluation for symptoms, and it's become clear that getting people the care they need sooner rather than later can produce better outcomes.

I've been wondering how this crisis will impact our national conversation on healthcare for all. Seeing how both patients and health care workers are faring in the absence of federal coordination and leadership may dramatically shift the landscape. 

 

Edited April 21, 2020 by Acadie

[Acadie]

10 hours ago, Jean in Newcastle said:

I checked it a lot when I has my “undetermined virus “ for six weeks. My O2 sats were generally ok until the last week. Then they started to dip (but came back up right at the time I was about to call the doctor). What was weird was those couple of days when my O2 sats started to dip my fingertips really hurt. I have never heard of that happening. 

 

Jean, this is wild! So glad you've recovered. 

I do think the pattern of O2 sats dropping late, and some tingling, pain or itchiness in fingers and toes are quite common in COVID-19. 

[AmandaVT]

I have this one and it works great: https://www.amazon.com/gp/product/B07V6STZDM/ref=ppx_yo_dt_b_asin_title_o06_s00?ie=UTF8&th=1

[Midwest Momma]

14 hours ago, Acadie said:

This article is excellent, and a real public service--

https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html?action=click&module=Opinion&pgtype=Homepage

Thanks for this info! I ordered a pulse oximeter, and my husband sent the article to his circle.

[ktgrok]

4 hours ago, FuzzyCatz said:

This is interesting and good to know,  but not everyone is going to be able to get one of these in the short term.  We’d all be better off if we could get better mask options too.

I have  read stories about EMT trying to convince people they don’t need transport to an ER and hospitals saying don’t come unless you’re really sick and testing being so limited.  I wish we’d put drive through quick places for people to get evaluated quickly with testing.  It’s a cultural and lack of insurance thing to wait to see a doctor here for many American families.  We are losing people and putting people on vents that with earlier treatment may have done fine at home with a nebulizer, or done with oxygen support, etc.  

Given that the tests have so many false positives, and subjective symptoms are showing to be a bad guide, I am thinking they need to start doing more chest xrays. Even if people don't seem that sick. I know that is increased radiation, but these days machines are much safer, and it would catch some of these people before they are too sick to save. 

[Jean in Newcastle]

I got my pulse oximeter because I had chest tightness and needed to know with some kind of objectivity when I might need medical help.  I have an inhaler but don't want to use it unless absolutely necessary because it messes with my heartrate and blood pressure.  So the oximeter was that objective measure that helped me decide what to do in the moment. 

[Guest]

Does anyone know if the readings on a Fitbit that tracks O2 during sleep are at all accurate?

[vonfirmath]

14 hours ago, kand said:

They appear much harder to come by than they were when I ordered one at the beginning of March, so you may have to go with whatever you can find. I paid less than $15 on Amazon, I was super glad to have it on hand while I was sick. Gave me some reassurance when I was feeling bad and starting to worry.

 

I also ordered one early after seeing Karen Kingsbury's SIL mention that they checked the pulse oximeter often to determine whether it was time to go to the hospital.

 

[sassenach]

14 hours ago, kbutton said:

Suggested models for reliable devices?

https://www.amazon.com/gp/product/B07R3TQF5J/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1

I have this one but it was just $20 when I bought it late last year. We have to have one for my son.

[Pen]

13 hours ago, Jean in Newcastle said:

I got one at my local pharmacy at the start of this. 
 

I checked it a lot when I has my “undetermined virus “ for six weeks. My O2 sats were generally ok until the last week. Then they started to dip (but came back up right at the time I was about to call the doctor). What was weird was those couple of days when my O2 sats started to dip my fingertips really hurt. I have never heard of that happening. 

 

I have Raynauds and it makes sense to me that fingers and toes would hurt if there’s not enough O2 flow.  Body tries to prioritize vital organs. 

[catz]

2 minutes ago, Ktgrok said:

Given that the tests have so many false positives, and subjective symptoms are showing to be a bad guide, I am thinking they need to start doing more chest xrays. Even if people don't seem that sick. I know that is increased radiation, but these days machines are much safer, and it would catch some of these people before they are too sick to save. 

Even if they had a listen to your chest and used a pulse ox in a parking lot, that could be a decent screener for people that might do better with an inhaler, etc or who might need an x-ray/oxygen therapy etc.  I have an untested presumed covid friend who had a medical family connection that got her some meds/inhaler/neb without a hands on appointment.  Obviously most people don't have a connection like that.  She recovered well at home over 2 weeks at so.   More people might be able to stay out of the hospital with earlier intervention.  

And I absolutely agree testing accuracy limitations are real.  One of the youngest deaths in our state had an initial negative test.

[Kassia]

1 hour ago, Pen said:

 

I have Raynauds and it makes sense to me that fingers and toes would hurt if there’s not enough O2 flow.  Body tries to prioritize vital organs. 

 

I also have Raynaud's and I have terrible chilblains on my right hand, which perfectly match what that article describes - they are red, swollen, and tender/painful with visible blood vessels.  

I think my O2 is fine, but I can't even get a reading on that hand because my circulation is so bad. 

Edited April 21, 2020 by Kassia

[Pen]

3 minutes ago, Kassia said:

 

I also have Raynaud's and I have terrible chilblains on my right hand, which perfectly match what that article describes - they are red, swollen, and tender/painful with visible blood vessels.  

I think my O2 is fine, but I can't even get a reading on that hand because my circulation is so bad. 

 

I hope you are okay.  Is O2 good on other hand?

[kbutton]

1 hour ago, Ktgrok said:

Given that the tests have so many false positives, and subjective symptoms are showing to be a bad guide, I am thinking they need to start doing more chest xrays. Even if people don't seem that sick. I know that is increased radiation, but these days machines are much safer, and it would catch some of these people before they are too sick to save. 

Locally they are noticing COVID findings on x-rays done for other reasons (and then testing people) or to rule out a differential diagnosis if someone has odd symptoms. I think it's a good idea. 

1 hour ago, dmmetler said:

Does anyone know if the readings on a Fitbit that tracks O2 during sleep are at all accurate?

I suspect it depends on what the information is used for--to show a trend vs. to get precise numbers. I have heard they are good for figuring out sleep disturbance patterns, for instance. 

[Pippen]

Facelake had oximeters in stock and shipped fast when I ordered a few weeks ago. At the time they were out of stock at Amazon, but when I checked the company website they had them, but at a higher cost. 

$39.95 + free shipping

https://facelake.com/

[Kassia]

39 minutes ago, Pen said:

 

I hope you are okay.  Is O2 good on other hand?

 

I hope so.  We sent our oximeter to our son when he came down with Covid-19 symptoms (he also has asthma) and I'm too stubborn to pay more for one now.  DH is worried because my fingers are so bad that there is some kind of underlying health issue.  I'm waiting (impatiently) for warmer weather to see if my fingers improve.  

I bought our pulse oximeter a few months ago thanks to all the coronavirus talk here and got it for a really good price.  I asked my son if he wanted one at the time and he said, "nah.  I'm good."  But then he got sick and wanted ours (and we wanted him to have it).  Now I am kicking myself for not sending him one when we bought ours when it was cheap and available.  

 

[Pen]

28 minutes ago, Kassia said:

 

I hope so.  We sent our oximeter to our son when he came down with Covid-19 symptoms (he also has asthma) and I'm too stubborn to pay more for one now.  DH is worried because my fingers are so bad that there is some kind of underlying health issue.  I'm waiting (impatiently) for warmer weather to see if my fingers improve.  

I bought our pulse oximeter a few months ago thanks to all the coronavirus talk here and got it for a really good price.  I asked my son if he wanted one at the time and he said, "nah.  I'm good."  But then he got sick and wanted ours (and we wanted him to have it).  Now I am kicking myself for not sending him one when we bought ours when it was cheap and available.  

 

 

It sounds like you need to be checked.

 Is your son better to send your meter back to you? Otherwise It would probably be worth buying one one even if they have gone up in price.  

The whole point of the article is that you can’t tell how you are without checking with a meter unless so sick it is largely “too late.”

can you get a telemedicine visit for your hand?

[Kassia]

Just now, Pen said:

 

It sounds like you need to be checked.

 Is your son better to send your meter back to you? Otherwise It would probably be worth buying one one even if they have gone up in price.  

The whole point of the article is that you can’t tell how you are without checking with a meter unless so sick it is largely “too late.”

can you get a telemedicine visit for your hand?

 

Sorry to steer this thread so far off topic.  

My son is better (thank goodness, we were scared), but he doesn't drive (he's on the spectrum) or have materials to package the oximeter back so he can't send it back.  I do want him to have it because of his asthma.  

I am sure my fingers aren't related to Covid-19 because I had this problem well before it was here.  But I don't know if there is another problem.  I did have a telemedicine visit and the doctor wanted me to be tested for lupus and scleroderma, but she couldn't order the labs since she isn't my primary doctor.  I don't really want to take the risk of going to a lab now anway.  She wanted to prescribe meds to reduce the vasculitis, but they lower blood pressure and I already struggle with low blood pressure.  So she prescribed a topical cream for the same purpose, but that also has a risk of lowered blood pressure and she said I would need to monitor my bp daily so I need to get a machine.  Still, that only treats the issue without knowing the underlying cause.  

 

 

[Ottakee]

2 hours ago, Medicmom2.0 said:

Our statewide protocol that has come out says there is an algorithm with suspected-Covid patients.  If you’re sick but not in distress And have no underlying conditions, we don’t transport. We have a sheet we give you that tells you to self isolate, take OTC fever reducers and stay hydrated.  But we check vitals including your oxygen saturation and we transport if any are out of the normal range.

Since our local hospitals, including the ER, are ghost towns, I’m interested to see if this mandate changes. 

Do you also look at heart rate in addition to oximeter?  I ask as my resting heart rate is 56-60 but when I am having trouble breathing my O2 might still be 98% but my heart rate is increased.

[ktgrok]

32 minutes ago, Ottakee said:

Do you also look at heart rate in addition to oximeter?  I ask as my resting heart rate is 56-60 but when I am having trouble breathing my O2 might still be 98% but my heart rate is increased.

Not her, but I've never known anyone to take vitals and not check pulse. Heck, most use a pulse oximeter that does both. 

[Jean in Newcastle]

55 minutes ago, Ktgrok said:

Not her, but I've never known anyone to take vitals and not check pulse. Heck, most use a pulse oximeter that does both. 

My pulse oximeter does both. In fact, when my O2 sats started dipping my pulse was over 100 (now its in the 70’s). And I could feel my heart pounding. 

[Ottakee]

1 hour ago, Ktgrok said:

Not her, but I've never known anyone to take vitals and not check pulse. Heck, most use a pulse oximeter that does both. 

Mine does too....my point was asking if they also consider heart rate or just go by the pulse ox number

[EmseB]

I keep thinking, this advice we all have been getting to stay home if we're sick and only seek treatment if breathing gets bad...what if treatment needs to start asap to be effective? The advice has never sat right with me because you're essentially telling people to wait until they are so sick they need a ventilator, which we know has bad outcomes. I know this is to limit contagion, but I feel like if people came in at onset and got the same meds (anti viral, whatever else is being tried) we might see better outcomes.

[Jean in Newcastle]

21 minutes ago, EmseB said:

I keep thinking, this advice we all have been getting to stay home if we're sick and only seek treatment if breathing gets bad...what if treatment needs to start asap to be effective? The advice has never sat right with me because you're essentially telling people to wait until they are so sick they need a ventilator, which we know has bad outcomes. I know this is to limit contagion, but I feel like if people came in at onset and got the same meds (anti viral, whatever else is being tried) we might see better outcomes.

Yes. And once this isn’t a novel virus, I am betting that treatment will be earlier and better. But we are still in the fairly early stages of a novel illness. They are triaging the most severe patients because there are shortages of tests and until very recently were still trying to figure out any kind of treatment. We’re a bit farther on the treatment discovery but we’re not far enough along on supplies to go to a more proactive approach. 

[Frances]

1 hour ago, EmseB said:

I keep thinking, this advice we all have been getting to stay home if we're sick and only seek treatment if breathing gets bad...what if treatment needs to start asap to be effective? The advice has never sat right with me because you're essentially telling people to wait until they are so sick they need a ventilator, which we know has bad outcomes. I know this is to limit contagion, but I feel like if people came in at onset and got the same meds (anti viral, whatever else is being tried) we might see better outcomes.

I agree. But I think the shortage of PPE is still a problem in many areas, hence the desire to see only the slickest people. It’s a vicious cycle. I know Germany was sending healthcare providers into the homes of patients and running tests there. often they were admitting people before they felt very bad.

[rebcoola]

I am so glad we have a pulse ox I would have not realized how sick my oldest is without it. Pulse 120, O2 ~93  It also gives a clear go to the ER now standard.

[klmama]

So what are the numbers for going to the ER?

[rebcoola]

O2 under 90 

[Arcadia]

10 minutes ago, klmama said:

So what are the numbers for going to the ER?

page 12 https://www.who.int/patientsafety/safesurgery/pulse_oximetry/who_ps_pulse_oxymetry_training_manual_en.pdf
“WHAT DO THE ALARMS ON A PULSE OXIMETER TELL YOU?
Alarms alert the anaesthetist to clinical problems. The alarms are as follows:
• Low saturation emergency (hypoxia) i.e. SpO2 <90%
• No pulse detected
• Low pulse rate
• High pulse rate

Low saturation alarm. The oxygen saturation in healthy patients of any age should be 95% or above.

‘No pulse detected’ alarm is commonly caused by the probe coming off the finger, but it may also be triggered if the patient is hypotensive, hypovolaemic, or has suffered a cardiac arrest. Check the probe site quickly and then assess the patient - ABC.

Pulse rate alarms are useful to let the anaesthetist know that the heart is beating too fast or too slow. However, alert anaesthetists will have already noticed the abnormal heart rate before the alarms sound. Children normally have higher heart rates than adults, but the same oxygen saturation – see table below.

Age Normal Heart Rate Normal oxygen saturation (SpO2)
* Exception: premature babies receiving oxygen therapy in the neonatal ICU should have an SpO2 between 89-94% to avoid toxicity to the retina. During surgery the oxygen saturation of premature babies should be maintained at >95%, as with all other patients.”

[Carol in Cal.]

Score--I asked for one at the pharmacy today, and they had them for sale behind the counter where the locked up drugs were.  Glad I tried.